The Ketogenic Diet And Type 2 Diabetes

The ketogenic (keto) diet, high in fat and low in carbs, can potentially change the way your body stores and uses energy, easing diabetes symptoms.With the keto diet, your body converts fat, instead of sugar, into energy.

The “keto” in a ketogenic diet comes from the fact that it makes the body produce small fuel molecules called “ketones”.

This is an alternative fuel for the body, used when blood sugar (glucose) is in short supply.

Ketones are produced if you eat very few carbs (that are quickly broken down into blood sugar) and only moderate amounts of protein (excess protein can also be converted to blood sugar).

Ketones are produced in the liver, from fat. They are then used as fuel throughout the body, including the brain. The brain is a hungry organ that consumes lots of energy every day,and it can’t run on fat directly. It can only run on glucose or ketones.

On a ketogenic diet, your entire body switches its fuel supply to run almost entirely on fat. Insulin levels become very low, and fat burning increases dramatically.

It’s based around the premise that your body was designed to run more efficiently as a fat burner than a sugar burner.

The diet was created in 1924 as a treatment for epilepsy, but the effects of this eating pattern are also being studied for type 2 diabetes. The ketogenic diet may improve blood glucose (sugar) levels while also reducing the need for insulin.

However, the diet does come with risks, so make sure to discuss it with your doctor before making drastic dietary changes.

Many people with type 2 diabetes are overweight, so a high-fat diet can seem unhelpful. The goal of the ketogenic diet is to have the body use fat for energy instead of carbohydrates or glucose. A person on the keto diet gets most of their energy from fat, with very little of the diet coming from carbohydrates.

The ketogenic diet has the potential to decrease blood glucose levels. Managing carbohydrate intake is often recommended for people with type 2 diabetes because carbohydrates turn to sugar and, in large quantities, can cause blood sugar spikes. If you already have high blood glucose, then eating too many carbs can be dangerous. By switching the focus to fat, some people experience reduced blood sugar.

Standard ketogenic diet (SKD): This is a very low-carb, moderate-protein and high-fat diet. It typically contains 75% fat, 20% protein and only 5% carbs.

Cyclical ketogenic diet (CKD): This diet involves periods of higher-carb refeeds, such as 5 ketogenic days followed by 2 high-carb days.

Targeted ketogenic diet (TKD): This diet allows you to add carbs around workouts.

High-protein ketogenic diet: This is similar to a standard ketogenic diet, but includes more protein. The ratio is often 60% fat, 35% protein and 5% carbs.

However, only the standard and high-protein ketogenic diets have been studied extensively. Cyclical or targeted ketogenic diets are more advanced methods, and primarily used by bodybuilders or athletes.

One study found that people on a ketogenic diet lost 2.2 times more weight than those on a calorie-restricted low-fat diet. Triglyceride and HDL cholesterol levels also improved .

Another study found that participants on the ketogenic diet lost 3 times more weight than those on the Diabetes UK’s recommended diet .

One study found that the ketogenic diet improved insulin sensitivity by a whopping 75% .

Another study in patients with type 2 diabetes found that 7 of the 21 participants were able to stop all diabetes medications.

There are several reasons why a ketogenic diet is superior to a low-fat diet. One is the increased protein intake, which provides numerous benefits.

The increased ketones, lowered blood sugar levels and improved insulin sensitivity may also play a key role .

The ketogenic diet can improve risk factors like body fat, HDL levels, blood pressure and blood sugar.The diet is currently being used to treat several types of cancer and slow tumor growth .

The diet may reduce symptoms of Alzheimer’s and slow down the disease’s progression .Research has shown that the ketogenic diet can cause massive reductions in seizures in epileptic children .One study found that the diet helped improve symptoms of Parkinson’s disease .

One animal study found that the diet can reduce concussions and aid recovery after brain injury .Lower insulin levels and eating less sugar or processed foods may help improve acne .

1.Some foods are ketogenic and some other food are anti-ketogenic.

Carbohydrates are 100% anti-ketogenic, meaning they completely turn into glucose once digested.

Fats are 90% Ketogenic, meaning 10% of the fat will turn into glucose in the bloodstream once digested.

Proteins are 46% Ketogenic and 58% anti-ketogenic,meaning that 58% of the proteins ingested will turn into glucose in the bloodstream.

2.Restrict your carbohydrates. Most people tend to only focus only on net carbs. If you want great results, limit both. Try to stay below 20g net carbs and below 35g total carbs per day.

3.Restrict your protein intake. Many people come over to keto from an Atkins diet and don’t limit their protein. Too much protein can lead to lower levels of ketosis. Ideally for weight loss, you want to eat between 0.6g and 0.8g protein per pound lean body mass.

While the exact cause of Type 2 diabetes is still not fully understood, it is known that being overweight or obese (having a body mass index – BMI – of 30 or greater) has a significant impact.

In fact, recent research suggests that obese people are up to 80 times more likely to develop type 2 diabetes than those with a BMI of less than 22.

So losing weight and bringing your BMI below this value is one of the most important, and controllable, ways to reduce your risk of Type 2 diabetes. And according to research, simply optimizing your protein intake can help you achieve rapid weight loss results – even with light-to-moderate exercising.

Thanks to Thinner You Centers, the following infographic on protein for weight loss contains science-based information about the effects of protein intake on body composition, and how to calculate your optimal protein intake for maximum weight loss potential!

4.Drink water. Try to drink a gallon of water a day. Make sure that you’re hydrating and staying consistent with the amount of water you drink. It not only helps regulate many vital bodily functions, but it also helps control hunger levels.

6.Add exercise in. It’s a known fact that exercise is healthy. If you want to get the most out of your ketogenic diet, consider adding in 20-30 minutes of exercise a day. Even just a small walk can help regulate weight loss and blood sugar levels.

7. Fasting On your ketogenic journey, it’s important to know that your success is not only dictated by eating enough fat and protein and restricting carbs. When you eat, how often you eat, and how much you eat have a substantial impact on your health and function as well.

Fasting isn’t required to lose weight on a ketogenic diet. If it doesn’t work for you, then do not force yourself to fast. Restricting yourself unrealistically is pointless – it’s not worth it if it makes you unhappy.

There are 2 basic terms we need to understand feeding and fasting. Your body is in a feeding state when you are eating your food, and you are in a fasting state when you are between your meals.

Ketogenic Diet Food List

Not sure what to eat on a ketogenic diet? Here’s a quick food list for you to reference.

In general, you can eat from the following food groups:

1.Fats & Oils

Try to get your fat from natural sources like meat and nuts. Supplement with saturated and monounsaturated fats like coconut oil, butter, and olive oil.

Fats will be the majority of your daily calorie intake when you are on a ketogenic diet, so choices should be made with your likes and dislikes in mind.

Fats are vital to our bodies, but they can also be dangerous if you are consuming too much of the wrong types of fats. There are a few different types of fat that are involved in a ketogenic diet.

Saturated Fats. Eat these. Some examples of these are butter, ghee, coconut oil, and lard.

Monounsaturated Fats. Eat these. Some examples of these are olive, avocado, and macadamia nut oils.

Polyunsaturated Fats. Know the difference. Naturally occurring polyunsaturated fats in animal protein and fatty fish are great for you, and you should eat these. Processed polyunsaturated fats in “heart healthy” margarine spreads are bad for you.

Trans Fats. Completely avoid. These are processed fats that are chemically altered (hydrogenated) to improve shelf life. Avoid all hydrogenated fats, such as margarine, as they’re linked to heart disease.

Saturated and monounsaturated fats such as butter, macadamia nuts, avocado, egg yolks, and coconut oil are more chemically stable and less inflammatory to most people, so they are preferred.

You also want to have a balance between your omega 3’s and omega 6’s, so eating things like wild salmon, tuna and trout can help provide a balanced diet of Omega-3’s. If you don’t like fish, or just prefer not to eat it, we suggest taking a small fish oil supplement. You can also take krill oil for omega 3’s if you are allergic.

Keep an eye on your intake for nut or seed based foods, as they can be quite high in inflammatory omega 6’s. These include items like almonds, walnuts, pine nuts, sunflower oil and corn oil. Eating fatty fish and animal meat, keeping snacking to a minimum, and not over-indulging in dessert items that are dense in almond flour is usually enough to keep your omega’s at normal ranges.

If you’re using vegetable oils (olive, soybean, flax, or safflower) choose the “cold pressed” options if they are available.

If you tend to fry things up, try to go after non-hydrogenated lards, beef tallow, ghee, or coconut oil since they have higher smoke points than other oils. This allows less oxidization of the oils, which means you get more of the essential fatty acids.

2.Protein

Try to stick with organic, pasture-raised and grass-fed meat where possible. Most meats don’t have added sugar in them, so they can be consumed in moderate quantity.

Cured meats and sausages can sometimes have added sugars and added processed ingredients avoid these. If you eat steak, try to choose fattier cuts like ribeye. If you like hamburger meat (ground beef), try to choose fattier ratios like 85/15 or 80/20 in some cases.

One thing you do need to be careful of when dealing with meat is your protein intake. Too much protein on a ketogenic diet can lead to lower levels of ketone production and increased production of glucose. You want to aim for nutritional ketosis, so you must not over-consume on protein.

Some examples of how to get your protein in on a ketogenic diet are below:

Offal/Organ. Heart, liver, kidney, and tongue. Offal is one of the best sources of vitamins/nutrients.

Other Meat. Veal, Goat, Lamb, Turkey and other wild game. Stick with fattier cuts where possible.

Nut Butter. Go for natural, unsweetened nuts and try to stick with fattier versions like almond butter and macadamia nut butter. Legumes (peanuts) are high in omega 6’s so be careful about over-consumption.

3.Vegetables

Fresh or frozen doesn’t matter. Stick with above ground vegetables, leaning toward leafy/green items.
Vegetables are tricky on a ketogenic diet because we’ve been raised under the idea that vegetables are healthy and they are. However, almost all of the vegetables that we consume today contain carbs.

Some more than others so it’s important to understand the ones that have a safer number of Net Carbs.

Vegetable

Amount

Net Carbs

Spinach (Raw)

1/2 Cup

0.1

Bok Choi

1/2 Cup

0.2

Lettuce (Romaine)

1/2 Cup

0.2

Cauliflower (Steamed)

1/2 Cup

0.9

Cabbage (Green Raw)

1/2 Cup

1.1

Cauliflower (Raw)

1/2 Cup

1.4

Broccoli (Florets)

1/2 Cup

2

Collard Greens

1/2 Cup

2

Kale (Steamed)

1/2 Cup

2.1

Green Beans (Steamed)

1/2 Cup

2.9

The best type of vegetables for a ketogenic diet are high in nutrients and low in carbohydrates. These, as most of you can guess, are dark and leafy. Anything that resembles spinach or kale will fall into this category and will be the best thing to include in anything you can.

If you can opt for organic as there are fewer pesticide residues, but if you can’t then don’t worry. Studies show that organic and non-organic vegetables still have the same nutritional qualities. Both frozen and fresh vegetables are good to eat.

Vegetables that grow below ground can still be consumed in moderation – you just have to be careful about the number of carbs that they have.In general, there’s no fitting rule that works perfectly. Try to choose your vegetables with carbohydrates in mind and portion them based on their carb counts.

Citrus. This includes lemon, lime, and orange juice (or zest) in water and in recipes.

Completely avoid starchy vegetables and large fruits like potatoes and bananas.

4.Dairy

Most dairy is fine, but make sure to buy full-fat dairy items. Harder cheeses typically have fewer carbs.Try to keep your dairy consumption to a moderate level. Most of your meals should be coming from protein, vegetables, and added fats/cooking oils.

Raw and organic dairy products are preferred here, if available. Highly processed dairy normally has 2-5x the number of carbohydrates as raw/organic dairy so it does add up over time. Make sure to choose full fat products over fat-free or low-fat as they will have significantly more carbs and less “filling” effects.

If you have lactose sensitivities, stick with very hard and long-aged dairy products as they contain much less lactose. Some examples of dairy you can eat on keto are:

Dairy is a great way to add extra fats into meals by creating sauces or fatty side dishes like creamed spinach, but always remember that it does have protein in it as well. You should always take this into account when pairing dairy with protein-heavy dishes.

Some people experience slower weight loss when over-consuming cheese. If you notice that you have hit a plateau or slowed down in weight loss, you may want to consider reducing the amount of dairy you eat.

5.Nuts and Seeds

In moderation, nuts and seeds can be used to create some fantastic textures. Try to use fattier nuts like macadamias and almonds.

Nuts and seeds are best when they are roasted to remove any anti-nutrients. Try to avoid peanuts if possible, as they are legumes which are not highly permitted in the ketogenic diet food list.

Typically raw nuts can be used to add flavorings or texture to meals. Some people choose to consume them as snacks – which can be rewarding but may work against weight loss goals. Snacking, in general, will raise insulin levels and lead to slower weight loss in the long term.

Nuts can be a great source of fats, but you always have to remember that they do have carbohydrate counts that can add up quickly. It’s also particularly important to note that they do contain protein as well. Nut flours especially can add up in protein rather fast – so be wary of the amount you use.

Nuts can also be high in omega 6 fatty acids, so it’s good to be careful with the amount you consume. For typical eating, you want to stick with fattier and lower carbohydrate nuts.

Fatty, moderate carbohydrate nuts. Walnuts, almonds, hazelnuts, peanuts, and pine nuts can be used in moderation to supplement for texture or flavor.

Higher carbohydrate nuts. Pistachios and cashews should rarely be eaten or avoided as they’re very high in carbohydrates (2 handfuls of cashews is almost a full day’s allowance of carbs).

If you have a nut allergy, a common substitution for almond flour is sunflower seed flour. Just keep in mind that this has higher levels of omega 6 fatty acids.

6.Beverages

Stay simple and stick to mostly water. You can flavor it if needed with stevia-based flavorings or lemon/lime juice.

The ketogenic diet has a natural diuretic effect, so dehydration is common for most people starting out. If you’re prone to urinary tract infections or bladder pain, you have to be especially prepared.

The eight glasses of water we’re recommended to drink? Drink those, and then some more. Considering we’re made up of about two-thirds water, hydration plays a substantial role in our everyday life. We recommend that you try to drink as close to a gallon of water a day as possible.

Many people experience the Keto Flu when transitioning to keto due to dehydration and lack of electrolytes. Make sure that you replenish your electrolytes and drink plenty of fluids.

Some examples of commonly consumed beverages on keto are below:

Water. This will be your staple, go-to source for hydration. You can drink still or sparkling water.

Broth. Loaded with vitamins and nutrients. More importantly, it will kickstart your energy by replenishing your electrolytes.

7.Herbs And Spices

Seasonings and sauces are a tricky part of ketogenic diet foods, but people use them on a regular basis to add flavor to their meals. The easiest way to remain strict here is to avoid processed foods. There are many low carb condiments and products on the market, and there’s no way to list them all. A handful of them are great, but the majority use high glycemic index sweeteners – which you want to avoid.

Spices have carbs in them, so make sure you are adding them to your counts. Sea salt is preferred over table salt, as it is usually mixed with powdered dextrose. Most pre-made spice mixes will have sugars added to them, so make sure you read the nutrition label beforehand to make sure you know what’s inside. If you have the choice, never include added sugar into your spice blends or food.

Below you’ll find some common herbs and spices that people use on a ketogenic diet. Always remember that spices do have carbs in them, so you should make sure to adjust your nutrition based on this.

Cayenne Pepper

Chili Powder

Cinnamon

Cumin

Oregano

Basil

Cilantro

Parsley

Rosemary

Thyme

Both salt and pepper can be used for seasoning without worrying about the nutritional information.

When trying to shift from a high carb diet to a ketogenic diet, cravings can definitely get strong. It’s always best to try to clean house before you start so that you don’t have food around you that can lead to cravings. We recommend that when switching to keto, you restrict using sweeteners completely for the first 30 days. It normally leads to breaking sugar addiction and ultimately not having cravings.

Ketogenic Diet Side Effects

The ketogenic diet may be a viable treatment option for some people with type 2 diabetes. However, it does have some potential side effects.

As the ketogenic diet entails switching to a different source of energy, it can lead to some side effects. These may include:

loss of salts

keto-flu

noticeable change in bowel habits, such as constipation

uncomfortable leg cramps

noticeable loss of energy

mental fogginess

frequent urination

headaches

In most instances, the above side effects are just temporary and people experience no long-term problems.

Long-term effects can include the development of kidney stones and an increased risk of bone fractures due to acidosis.Children may also experience stunted growth due to reduced levels of an insulin-like growth factor that can lead to bone erosion. This can mean weak bones that are highly susceptible to fractures.

If you are pregnant or are nursing, you should not follow a Ketogenic diet.

You will not receive enough of the recommended carbohydrates, vitamins and nutrients necessary for yourself and your growing baby on this diet.

Your obstetrician will recommend how many carbohydrates you should consume per meal and for snacks during each phase of your pregnancy. They will likely refer you to a Certified Diabetes Educator for nutritional counseling as well.

Some studys suggest that people with type 2 diabetes taking oral medication to lower blood sugar levels may be more at risk for hypoglycemia, or low blood sugar, when following a ketogenic diet.

Consult with your diabetes medical team including your endocrinologist and a registered dietitian who is also a certified diabetes educator before trying this eating plan. You’ll want to start the Ketogenic diet slowly, cutting carbohydrates gradually.

You’ll want to regularly test both your blood sugar and ketone levels to prevent serious side effects. You’ll also want to make sure you’re taking in a balance of nutrients — all of those important vitamins, minerals, fiber as well as the proper amount of calories and healthy fats.

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